Approach to reduction of vascular complications of percutaneous valvuloplasty.

The large-bore arterial sheaths required for balloon valvuloplasty and intraaortic balloon pumps may be associated with substantial morbidity when introduced into the superficial femoral artery in elderly people, especially women and those with peripheral atherosclerosis. We report a total occlusion of the superficial femoral artery by a large intravascular sheath requiring subsequent surgical intervention. A femoral arteriogram using less than 10 cc of contrast through a 5F catheter can assure placement of the puncture into the common femoral artery prior to introducing the large sheath or catheter, thus reducing morbidity.